US HIV guidelines update information on integrase inhibitors (Oct 2013)
On 30 October 2013, the US DHHS treatment guidelines were updated to include new recommendations on the use of integrase inhibitors.
The guidelines recognise advantages and disadvantages for each of the three approved integrase inhibitors (dolutegravir is approval is expected shortly in Europe). Previously, raltegravir was a preferred option and elvitegravir was only included as an alternative.
The guidelines now recommend the following four integrase inhibitor-based regimens as preferred regimens for ART-naive patients (all rated AI, arranged in order of drug approval).
- Raltegravir 400 mg twice daily plus tenofovir 300 mg/emtricitabine 200 mg once daily
- Elvitegravir 150 mg/cobicistat 150 mg/tenofovir 300 mg/emtricitabine 200 mg once daily in patients with estimated CrCl ≥70 mL/min
- Dolutegravir 50 mg once daily plus abacavir 600 mg/lamivudine 300 mg once daily in patients who are HLA B*5701 negative
- Dolutegravir 50 mg once daily plus tenofovir 300 mg/emtricitabine 200 mg once daily
Panel Statement on Integrase Inhibitor Use in Antiretroviral Treatment-Naive HIV Infected Individuals. 30 October 2013.